Proof of Service PersonalCal. Super. - 6th Dist.January 4, 2021' Clerk stamps date here when form is filed. CH-200 Proof of Personal Servuce ® Person Seeking Protection F I L F nNamei DINAV JONES® Person From Whom Protection Is Sought JAN 2 8 2021 Name: VENKATESH SRINNASAN ® Notice to Server The sewer must: 7: E ' Be l 8 years 0f age 0r Older- /;‘§ f K Fill in court name and street address: . Nm be listed in items (D or© f )I ,\ ’ s 7‘ ' 117) superior Court of California, County of of Fonn CH-loo. F‘» f? N SANTA CLARA ° Give a copy of all documents checked in@ to the person in®. 19' NORTH FIRST STREET (You cannot send them by mail.) Then complete and sign this SAN JOSE, CA 95 l 13 form and give or mail it to the person in ®. J .-~__ PROOF OF PERSONAL SERVICE Court fills in case number when form is filed. _ Case Number: Q) I gave the person In®a copy of the forms checked below: 21CH009793 CH-109, Notice ofCour! Hearing CH-l 10, Temporary Restraining Order Q CH-IOO. Requestfor Civil Harassment Restraining Orders CH-l20. Response t0 Requestfor Civil Harassment Restraining Orders (blank form) m CH-lZO-INFO, How Can l Respond t0 a Requestfor Civil Harassment Restraining Orders? D CH-l30. Civil Harassment Restraining Order After Hearing CH-800, ProofofFirearms Turned In, Sold, 0r Stored (blank form) Other (speciMCM-mo; cv-0514; CH-250(Blank Form); Fw-oo1 (Blank Form); Fw-003(Blank Form) p‘qarthP-PP‘P ® [personally gave copies of the documents checked above to the person in ®: a. On (date): 015145202] b_ At(time): 3.49 D a.m. E p.m. c. At this address: 5892 CANDENCE AVE City: mm. 1N State: (‘A ZiPI 94mg ® Server's Information Name: 1A" nMA GHAanRI Addressi 57m QTONFRIDGF MAI I ROAD QI nTF mo City: £LFA§ANT0N State: CA Zip: 04m: Telephone: 975-572-1107 ([fyou are a registeredprocess server): County of registration: A1 AMpnA Registration number: ”29 I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: 01 /1 5/2021 jLAILOMA GHAFOORI ’ 731w or print server ‘s name Sum: here/ ( J"Coul1cm . , H CH-200.P 1of1Rggmfi gmfgp'zgamfimmw Proof of Personal Ice 39° 0°“ °'°'V"PW“ 5 527-6 (Civil Harassment Prevention)
